Of Semmelweiss and hand hygiene in the times of Covid-19

on
13 March 2020
Handwashing to prevent the spread of Corona virus

Corona Virus is currently occupying our collective mind space.  Apart from avoiding mass gatherings, the foremost message given through public media and health advisories across the world is on hand hygiene. It has been advised to clean your hands regularly and thoroughly with soap and water or with an alcohol-based sanitizer. That’s the first and most effective line of defense. And suddenly, the humble everyday act of washing hands seems like the preventive saviour.

In times of COVID-19 which the WHO has now declared as ‘pandemic’ it’s become critical and has been advised to wash hands when one has used public transport such as buses, metro, train or airplanes; or being to public places such as offices, factories, malls or parks. Handwashing is critical after coughing or sneezing. It is also important before preparing food or eating as well as after toilet use or touching animals.

It is most important for healthcare providers to wash hands before and after taking care of the unwell.

There is a poignant story behind handwashing as a key preventive measure in the history of health and hygiene. And it is important to remember it in the times of Covid-19.

In the 19th century, there was a Hungarian Physicist, Ignaz Philipp Semmelweis, who pointed out that one of the key reasons behind new mothers dying in the maternal wards was that the doctors were carrying germs in their hands, while going from one patient to another. And if handwashing was practiced by doctors before attending a patient or between two patients, maternal mortality could be stopped.  No one of course heard Semmelweiss during his lifetime and even treated him as a mad person.

His contemporary doctors were offended by the suggestion of handwashing. Hand hygiene was considered too naïve and unscientific to be a leading cause of mothers’ deaths in maternal wards.

Semmelweiss only got due recognition many years after his death and is now known and referred as the ‘Saviour of Mothers’, a pioneer of antiseptic theory. Gradually, handwashing and hand hygiene were accepted as key clinical preventive practices for infection prevention and control (IPC) in due course of time.

It was much later, years after Semmelweis’s death, that Louis Pasteur confirmed the ‘germ theory’ and Joseph Lister (based on microbiological research) showcased and practised operations based on hygienic methods.

The movie ‘That Mothers Might Live’  based on Semmelweis’s struggle for cleanliness and handwashing even won an Oscar in 1938 for Best Short Subject.

Even after it being proven and established that hands can carry germs and therefore need to be washed by following the correct method,   there is a sort of apathy towards a simple thing like hand-washing.

Globally, one out of six (16%) healthcare facilities  lack  hygiene services, i.e. they do not have handwashing  facilities with soap and water at points of care, as well as near toilets according to a  report WASH in Health Care Facilities by WHO and UNICEF.

Unfortunately, the correct way of handwashing by people at critical points of contact and after specific activities is still lacking as a part of key behaviour practices.

In times of COVID-19 that’s resulting in a global shutdown of sorts, proper handwashing at crucial points is an easy yet sure shot deterrent in preventing spread the spread of coronavirus. It is important that apart from the information dissemination, equally important is to have proper facilities to wash hands with soap and water which are easily accessible and available to all, including the urban poor in slums or people living in the  hinterlands.

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